Blood cancers

Dr Kyohei Nakamura: can the Samurai warrior spirit help defeat MM?

Wednesday, 18 Apr 2018

Challenge: can you describe the aim of your research in 10 words?

To better understand the immune microenvironment underpinning multiple myeloma.

What have you discovered in this area so far?

Our major finding is that IL-18 is abundantly released in the myeloma environment, which contributes to generation of the immunosuppressive microenvironment. We found high levels of IL-18 in the bone marrow were indicative of a poorer prognosis in myeloma patients. In other words, our finding indicated that IL-18 is a critical factor in the vicious cycle of immunosuppression and inflammation in multiple myeloma.

How did IL-18 and myeloid-derived suppressor cells become the focus of your attention?

Based on the fact that myeloma progression is closely linked with tissue injury in the bone marrow, I hypothesised that the sterile inflammatory response may be a critical feature of myeloma-associated inflammation. I received my clinical training in haematology and rheumatology in Japan. This clinical background has helped with the development of this project.

What aspect of this research excites you the most?

Our finding on the prognostic impact of IL-18 in patients was a really exciting moment for me. We found high levels of IL-18 in the bone marrow were indicative of a poorer patient prognosis, independent of factors such as age, clinical stage of disease or chromosomal abnormalities.

How far is your work from impacting patient care?

As a clinician, I am deeply cognisant of the fact that it takes a long time to translate exciting research findings into patient care. The impact of IL-18 in the bone marrow on prognosis will need to be confirmed in a large cohort study of patients. To develop anti-myeloma therapies by targeting myeloma-associated inflammation and immunosuppression, we will need to continue this work over the long-term. It is a challenging road ahead, but we are excited by the potential impact on patient care.

What are the next steps in this line of research?

To develop effective anti-myeloma therapies, we first need to gain an in-depth understanding of the molecular mechanisms of myeloma-associated inflammation. Additionally, we need to determine the best strategy to control tumour promoting inflammation in myeloma. We also need to develop our knowledge of how anti-myeloma therapies affect inflammatory responses in the myeloma microenvironment.

What is your research Holy Grail – the one thing you’d like to achieve?

I would like to improve patient outcomes through my research. This is a simple, but ultimately an exceptionally challenging goal.

What is your biggest research hurdle?

Like many researchers, I face the types of hurdles that are common in science, such as disappointing experiment results, unique time pressures and grant writing. However, the biggest hurdle I have experienced were the clinical problems patients had to face. So, how can we improve patients’ outcomes? As a clinician scientist, this has been my biggest hurdle.

Who has inspired you in work or life?

I have been inspired by Bushido, the code of conduct of the samurai warriors. Though it was established hundreds years ago in my home country, it still has a strong impact on my way of work and life. It often motivates me to achieve my goals.

 Describe your perfect day.

My perfect day would be spending time with my family here in Australia, enjoying some of the amazing wildlife unique to this country. We wish to visit Kangaroo Island in the near future.


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